Provider Demographics
NPI:1932787504
Name:GUILLEN RAMIREZ, JAVIER (DDS)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:GUILLEN RAMIREZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10400 SW 108TH AVE APT A102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-8622
Mailing Address - Country:US
Mailing Address - Phone:786-719-0564
Mailing Address - Fax:
Practice Address - Street 1:10400 SW 108TH AVE APT A102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8622
Practice Address - Country:US
Practice Address - Phone:786-719-0564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL283651223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program